Ahiphena (Opium): Bridging Ayurvedic Wisdom and Modern Toxicology

 Ahiphena (Opium): Bridging Ayurvedic Wisdom and Modern Toxicology

Category: Agadtantra (Toxicology)

Bams 2 nd year

In the world of Agadtantra (Ayurvedic Toxicology) and modern forensic medicine, few substances are as fascinating—and dangerous—as Ahiphena, commonly known as Opium or the Poppy plant. Known for its potent medicinal properties and high potential for abuse, understanding Ahiphena requires a look at both its traditional Ayurvedic classification and its modern pharmacological profile.

Introduction

• Latin Name : Papaver Somniferum.
• Family: Papaveraceae.

Vernacular Names 

• Sanskrit : Aaphuk, Ahiphen, Naagphen,   Niphen, Amal.
• Marathi : Aphu
• Hindi: Afim
• English: Opium, Poppy plant .

Classification:

According to Ayurved -

Sthavara vegetative poison

Upavisha (Bhavaprakash & Rasatarangini)

According to Modern science -

Neurotic Cerebral Somniferous

Properties 

• Guna: Laghu, Ruksha,Sukshma, Vyavayee, Vikasee.
• Rasa: Tikta.

• Vipaka : Katu.
• Veerya: Ushna.
• Prabhav: Madak.

Utpattisthana:

Europe, Asia, South Africa and in India specially Uttar Pradesh, Bihar, Bengal, etc.

General Description

It is a perennial shrub of height 1 to 1.5 m.

It is called as Poppy.

Stem- It is branchless & smooth.

Leaves -Rectangular, alternate.

Flowers- Large, white, purple or reddish black in colour.

Fruit - There are 5 to 8 fruits in each plant.

 fruit is like small pomegranate fruit with stalk.

It breaks by itself.

Seeds -It is called as Khaskhas.

These are harmless as they do not contain

the toxic principle of opium i.e. morphine.

Toxic part ( vish Adhishthan )

Extract from poppy capsule (Phala Niryas) i.e.

Opium

• Active principle

Morphine. : The other toxic contains which

are in less quantity are-

a) Natural derivatives -

Codein, Papaverine, Narcotine.

b) Semi synthetic derivatives

Heroin (brown sugar)

c) Synthetic derivatives - Pethidine.

Mechanism of Action:

Morphine depresses the cortex & the

respiratory

& cough centers in medulla but

stimulates vagus & vomiting centers.

Fatal dose

Morphine - 200mg,

Opium - 2 gm

Tincture of opium 10ml

Codein - 500 mg

Heroin - 50 mg & Pethidine - 1 gm.

Fatal Period: 6 to 12 hours.

TOXIC SYMPTOMS

Acute poisoning.

a) External poisoning-

In sensitive people redness of skin,

blisters & itching may be caused due to opium.

b) Internal poisoning-

Opium contains Morphine in large doses

so the poisoning due to opium is due to Morphine only.

If opium is taken by oral route, the symptoms appear

in 1/2 to 1 hour & if it is injected then the

symptoms appear within 3 to 4 minutes because

when it is taken by oral route

the toxicity is reduced due to metabolism in liver.

Three stages can be seen in opium poisoning which are as follows -

1] Stage of Excitement.

1.   Transient stage; may be absent in large doses
2.   Feeling of well-being and euphoria
3.  Increased mental activity and talkativeness
4. Freedom from anxiety, laughing, restlessness
5.  Flushing of face and increased heart rate
6.  Hallucinations may occur
7. Convulsions can occur in children

2.Stage of Stupor.

1.   Incapacity for exertion and strong desire to sleep
2. Headache, nausea, vomiting, and vertigo
3.  Functional loss of senses
4.  Lies motionless with eyes closed (sleep-like state)
5.  Initially arousable, later passes into stupor and coma
6.  Pupils constricted;  face and lips cyanosed
7. Pulse and respiration nearly normal; itching over body

3.Stage Of Narcosis.

1.   Deep coma; patient cannot be aroused.
2.  Muscles flaccid, reflexes abolished.
3.  Pinpoint pupils not reacting to light.
4.  Slow, stertorous respiration (may fall to 3-4/min)
5.  Weak pulse initially; later slow, full, and irregular
6.  Cold skin with sweating; subnormal temperature
7. Respiratory depression →Cheyne-Stokes breathing → death by asphyxia

Purification Method Of
AHIPHENA

Shodhan of AHIPHENA (OPIUM).

• A First, dissolve the opium extract in water.

• The mixture should be strained through a cloth and physically purified.

• Then, add a little cow's milk and digest it over a low flame.

• After it becomes thick, remove it from the fire and let it cool.

• The physically purified and processed opium should be taken in a khala

and given 7 to 21 bhavanas (processes) with ginger juice.

-Ref- Rasatarangini.

Symptoms of Chronic poisoning:

The addiction of opium is called as Morphinism or Morphinomania.

With long term consumption the patient becomes restless, irritable, sleep

disturbance (insomnia) or sleep is disturbed by dreams,

loss of memory.

Mental fatigue, gradual intellectual & moral deterioration occurs,

constipation, weakness, contracted pupils. In these patients

impotence is frequently seen.

Differential Diagnosis:

•  Acute alcoholic poisoning
•  Barbiturate poisoning
• Diabetic coma
•  Uremic coma
•  Epileptic coma
•  Hysterical coma
•  Carbon monoxide (CO) poisoning
•  Apoplexy
•  hemorrhage.
•  Brain trauma
•  Meningitis
•  vomi Encephalitis
•  Cerebral Malaria
•  Heat Hyperpyrexia

Treatment of Poisoning

According to Ayurved

• If patient is conscious give powder to induce emesis.

• Give Baked asaphoetida, mixed in milk.

• Give Tankan Laahi (borax) with clarified butter.

• Juice of ginger should be given.

• The decoction of cotton seed, Erand seed or Amalki

decoction should be given.

• The antidotes for opium according to Ayurved are follows

Cotton seed, Cows's clarified butter, Neem, Tea etc.

• To empower heart & to protect heart from toxic effect,

give remedies of gold like Hemagarbha Maatra, Suvarna Sootshekar, etc.

• In comatose patient, the Kat'phalaadi snuff, should be used.

Give collyrium of

chandrodayaa varti or Ardha naari Nateshwar, Makaradhvaja or Kasturi should

be used by taking incision on vertex (kaakpada chedaa).

According to Modern science

• Treatment for Acute poisoning

• The emetics usually fail due to the depression of vomiting center.

Gastric lavage:

• first give gastric lavage with warm water & preserve this first lavage

water for chemical analysis.

• Then use KMNO4 in 1:5000 concentration for gastric lavage.

• To preserve this lavage content is of no use because opium is oxidized by KMNO4 &

forms a harmless product & opium cannot be detected in chemical analysis.

• The stomach wash is continued until the brownish colour of the stomach wash content

is changed to original pinkish colour of KMNO4.

• In opium poisoning, stomach wash is useful even if the route of opium poisoning

parenteral as morphine is secreted in stomach.

• In the unavailability of KMNO4 use boiled tea, tannic acid or combination of fine

powder of activated charcoal & water

Use of purgatives :

Give enema or use purgative drugs like MgSO4 15-30 gm by oral

route so that entire gastrointestinal tract is kept clean that restricts

the reabsorption of opium through GIT

Inj. Naloxone HCL is a pure antagonist of Morphine so

it is given in 0.4 to 0.8 mg IV/I.M/sublingually every 10-15 min until

following signs appears:

1. Dilatation of pupils
2. Regular & Normal respiration
3. Patient regains consciousness.

If necessary antidote can be given through endotracheal intubation.

b. Inj. Nalmefene & Tab. Naltrexone may also be used as antidote.

c. Although Atropine is antidote it is not recommended as it can cause death by paralysis of sensory & motor nerves.

d. Nalorphine & Levallarphan are specific antidotes for opium but not recommended due to their respiratory depressant & hallucinatory properties

General Treatment-

a) After patient is seen in early stage, he should be made to walk about in the open air that helps excretion of opium, but if poison has been absorbed & is acting upon cells of the cortex it may do more harm than help by further exhausting the patient.

b) Keep the patient warm.

c) Hot tea or coffee should be given orally or by rectal route

Symptomatic Treatment

• IV DNS should be given in shock.
• Inj- 25% coramine 5-10 ml IV may be given as a respiratory stimulant drug.
• Stimulant drugs like Methyl amphetamine HCL 10-20 mg may be given If patient lands in deep coma, artificial respiration should be carried out continuously & oxygen given by inhalation
•  To avoid infection of respiratory tract, antibiotic should be given

Treatment of Chronic poisoning of opium:

• Psychiatric counseling should be done.
• Gradual withdrawal of Morphine.
• Beta blockers should be used to relieve anxiety & craving.
• Antispasmodics should be used for abdominal colic; vomiting & diarrhea.

Post-Mortem appearances

A) External-

•  Smell of opium is noticed.
•  Face is deeply cyanosed & blackish discoloration is seen on face.
•  Signs of asphyxia are observed.
•  The veins of neck are edematous.
•  Postmortem staining is well marked & cyanotic.
•  Froth is seen at mouth & nostrils.
•  In patient with addiction many needle prick marks can be seen.

B) Internal -

• The stomach may contain small lumps of opium. On opening the chest, the smell of opium is noticed, but it disappears if putrefaction has set in. Opium disappears rapidly from the cadaver.Trachea, bronchi, lungs, brain & organs of abdomen are congested. Trachea & bronchi are covered with froth. Lungs are oedeomatous.

• Cyanotic post mortem staining & oedeomatous lungs are the two diagnostic signs for opium poisoning.

• If opium poisoning is suspected, then blood, bile, & brain are preserved along with routine organs.

Test for detection of opium:

Marquis test:

Suspected opiate solution is taken in a test tube, to it added a drop of mixture containing 3 cc of conc. 

Sulphuric acid and3 drops of formalin. Colour changes from purple red to violet and finally to blue will be diagnostic.

MEDICINAL PREPARATIONS:

Ahiphenaasava

Harshodaya Vati

Medico Legal Aspects:

•  Opium is the ideal suicidal poison.
•  Rarely used for homicidal.
•  Accidental poisoning is common in infants and children.
•  Morphine is a drug of addiction.
•  It considered an aphrodisiac.
•  Body may decompose rapidly.
•  Body packer syndrome refers to the intentional ingestion or insertionof well-packaged drug packes into the body for smuggling, 

with risks of obstruction, perforation, or life-threatening toxicity if a packet rupture

•  Body Stuffer Syndrome refers to the intentional swallowing or hurried ingestion of poorly packaged illicit drugs (e.g., cocaine, heroin) to evade detection, 

often during law enforcement encounters, posing a risk of toxicity due to packet rupture or leakage.